abortion 流产
Abortion 流产
I Definition Abortion is termination of pregnancy before 28 weeks of gestation and nd the fetal weight is less tan 1000 a Abortion: spontaneous: 10%0-18% artificial I The early abortion: occurs before 12w The late abortion: occurs after 12w
Ⅰ. Definition ◼ Abortion is termination of pregnancy before 28 weeks of gestation and the fetal weight is less tan 1000g. ◼ Abortion : spontaneous: 10%~18% artificial ◼ The early abortion: occurs before 12w ◼ The late abortion: occurs after 12w
2.Etiology -(1)Heredity factors Abnomalities of chromosomesis the commonest cause of Spontaneous abortion Early abortion 50%0-60%o is caused by chromosomal abnormalities
2.Etiology ◼ (1)Heredity factors Abnomalities of chromosomesis the commonest cause of Spontaneous abortion. Early abortion 50%~60% is caused by chromosomal abnormalities
(2)Maternal factors ① )the general diseases ② endocrine disorder
(2)Maternal factors ◼ ①the general diseases ◼ ②endocrine disorder
③ the genital disease A uterine deformity a B pelvic tumor(myoma, ovarian tumor aC cervical incompetence. laceration abdominal operation during the pregnancy
◼ ③the genital disease ◼ A.uterine deformity ◼ B.pelvic tumor(myoma, ovarian tumor) ◼ C.cervical incompetence, laceration ◼ ④abdominal operation during the pregnancy
■(3) Toxic factors lead, mercury, DDT, radiation, X-ray (4)Immunologic factors Blood type in compatibility between mother and fatus Imcompatibilily due to abo, rh
◼ (3)Toxic factors: lead, mercury, DDT, radiation, X-ray ◼ (4)Immunologic factors Blood type in compatibility between mother and fatus. Imcompatibilily due to ABO, Rh
3. Pathologic change Most commonly, necrotic changes occur in the decidual tissue about the placentation site and result in hemorrhage into this area As bleeding continues, the sac and the placenta become detached from the uterine wall and are expelled by uterine contractions
3.Pathologic change ◼ Most commonly, necrotic changes occur in the decidual tissue about the placentation site and result in hemorrhage into this area. As bleeding continues, the sac and the placenta become detached from the uterine wall and are expelled by uterine contractions
4 Clinical classification and feature (I) Threatened abortion (2)Inevitable abortion a(3)Incomplete abortion ■(4) complete abortion (5)Missed abortion a(6)Habitual abortion ()Septic abortion(infect abortion
4.Clinical classification and feature ◼ (1) Threatened abortion ◼ (2)Inevitable abortion ◼ (3)Incomplete abortion ◼ (4)complete abortion ◼ (5)Missed abortion ◼ (6)Habitual abortion ◼ (7)Septic abortion(infect abortion)
Differential diagnosis of varied abortions Threatened Inevitable Imcomplete Complete History Bleeding Slight Middle→ severa Slight-→ severa Slight→no Abdominal pain No/slight Aggravate Decrese Tissues are Ne Yes(partial) Complete Gynecologic examination Cervical os Close Open Open/tissue block Close Uterine size Consistent with =/slight small /slight larger Pregnancy test Treatment Protect fetus Curettage Curettage no principle
Differential diagnosis of varied abortions Threatened Inevitable Imcomplete Complete History Bleeding Slight Middle→severa Slight→severa Slight→no Abdominal pain No/slight Aggravate Decrese No Tissues are expelled No No Yes(partial) Complete Gynecologic examination Cervical os Close Open Open/tissue blochk Close Uterine size Consistent with =/slight small < =/slight larger Pregnancy test + +/- +/- +/- Treatment principle Protect fetus Curettage Curettage no
Missed abortion a It is that pregnancy has been retained for 2 months or more following death of the fetus a The abnormally protracted retention of a dead fetus in uterus in over 2 months that don t expelled a Missed abortion is manifested by loss of symptoms of pregnancy and decrease in uterine size
Missed abortion ◼ It is that pregnancy has been retained for 2 months or more following death of the fetus. ◼ The abnormally protracted retention of a dead fetus in uterus in over 2 months that don’t expelled. ◼ Missed abortion is manifested by loss of symptoms of pregnancy and decrease in uterine size
